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NPI Code Detail

MEDICARE: DR. MARK STEVEN CAMPBELL M.D.

MEDICARE: DR. MARK STEVEN CAMPBELL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician39321CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770571432
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK STEVEN CAMPBELL M.D.
Provider Business Mailing Address
First Line : PO BOX 1450
Second Line :
City : DOUGLAS
State : WY
Zip : 82633-1450
Country : US
Telephone Number : 307-358-2122
Fax Number : 307-358-7347
Provider Business Practice Location Address
First Line : 111 S 5TH ST STE 2
Second Line :
City : DOUGLAS
State : WY
Zip : 82633-2434
Country : US
Telephone Number : 307-358-7365
Fax Number : 307-358-7347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 11/06/2013

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